The NMHDU Mental Health Act (MHA) Implementation Programme Children and Young People's workstream is a continuation of the NIMHE programme, and will be in place until April 2010. The programme concentrates in 2009/2010 on supporting areas to get ready for the commencement of the new duty to provide an age appropriate environment (subject to need) for all under 18s who require inpatient mental health care. A key part of this support is to encourage areas to develop alternatives to admission as well as appropriate and safe inpatient resources.
The programme was created in consultation with young services users, parents, carers, advocates, professionals and lawyers and details can be found on this website. Individual products to help young users, cares and professionals created by the programme are as follows:
Getting ready for April 2010
The Government is committed to commencing the new duty to provide age appropriate environments for young people under the age of 18, subject to need, from April 2010. Although there has been remarkable progress by many areas, there is still a shortage in some areas of admission prevention and emergency CAMHS inpatient provision in some areas, and as a consequence, 16 and 17 year olds may still need to be admitted to an adult ward, albeit breifly, in an emergency. For some 16 and 17 year olds, an adult ward may be the most appropriate environment for them clinically and socially, but even in these 'atypical' appropriate placements, there are still important considerations for adult wards admitting minors.
The Royal College of Psychiatrists Research and Training Unit has worked with young people, parents, clinicians and commissioners from AMHS and CAMHS to develop the Safe and Appropriate Care for Young People on Adult Wards. Download the information flyer, joining form and a report into the pilot
The AIM programme of accreditation has now built this into its accrediation programme, and wards which are admitting under 18s now and which may still do so post April 2010 can now be accredited.Visit the Royal College site for additional information
Consent to admission and consent to treatment, flow charts for under 16 year olds and 16 and 17 year olds.
The law on consent for 16 and 17 year olds changed in January 2008. The revised Code of Practice also detailed guidance on consent for under 16 year olds. The issues regarding consent for treatment and admission are complex and are extensively explored in the The Legal Aspect of the Care and Treatment of Young People with Mental Disorder:A Guide for Professionals which is available to download below or in hard copy.
These flowcharts have been designed for adult and CAMHS wards, and should be viewed in conjunction with the guide. They are available to download opposite and print in four and two colour, and black and white. A limited number of laminated flowcharts are available from Magdalena.milejczak@nmhdu.org.uk
Safe and Appropriate Care Pilot
The Royal College of Psychiatrists Research and Training Unit were commissioned in 2008 to identify safe and appropriate care for young people on adult wards, in preparation for the new duty to provide an 'age-appropriate environment from April 2010. The document is aimed at any ward that may on occasion have to admit a young person under 18 in an emergency, as well as those under 18 for whom such a placement is clinically appropriate.
This was developed and piloted in 26 adult wards across England. .
The pilot report highlights areas of concern, particularly in training and safeguarding, and access to CAMHS support. It makes a number of recommendations, including
-designating wards in advance
-defined liaison for adult wards from one CAMHS team
-closer joint working by commissioners of AMHS and CAMHS
-workforce development and training
- performance monitoring by SHAs
-monitoring of commissioning and provision of services for under 18s by the CQC
New good practice report for inpatient services with young service users with acute mental health needs
This is an excellent report by Lancashire Care Trust and The Junction which details a review of inpatient services at the Trust by young service users, with recommendations for changes to ensure that young people get a service which is more appropriate. The report references the 11 Million reports, Pushed into the Shadows and Out of the Shadows, and the Safe and Appropriate Care for Young People on Adult Wards developed by the Royal College of Psychiatrists Research and Training Unit commissioned by the NMHDU Children and Young People's MHA Implementation Programme which were recently commended by the MHAC Biennial Report.
Please download the report here.
In Our Own Words, a DVD for training services to take account of the needs of children and young people
In Our Own Words' is a new DVD for training services to take account of the needs of children and young people who may require admission for mental health problems. It details the experiences, both good and bad, of young people and their parents, and includes reflections by advocates and professionals on issues such as admission, treatment, safety, age appropriate environments and discharge planning. View the DVD here
Working Together To Provide Age-Appropriate Environments And Services For Mental Health Patients Aged Under 18. June 2009.
A briefing for commissioners of Adult Mental Health Services and Child and Adolescent Mental Health Services.
This briefing has been written to support commissioners of both Adult Mental Health Services and Child and Adolescent Mental Health Services to prepare to meet the requirements of a new duty within the Mental Health Act 2007, amending the 1983 Act, to admit and treat patients aged under 18 into an environment in hospital which is suitable having regard to their age (subject to their needs). The Government has committed to commencing this duty in April 2010, with the purpose of preventing the inappropriate admission of children and young people to adult psychiatric wards. By working together, commissioners of both Adult Mental Health Services and Child and Adolescent Mental Health Services can develop more effective services to maintain young people in the community when it is safe to do so, and appropriate inpatient resources to meet their needs in a crisis or for medium to long term treatment.
Hard copies of the briefing are available from Magdalena.milejczak@nmhdu.org.uk
The Legal Aspect of the Care and Treatment of Young People with Mental Disorder: A Guide for Professionals
A Guide for Professionals regarding the interaction between the Mental Health Act, the Mental Capacity Act and Childrens' legislation.
Hard copies of the guide are available from Magdalena.milejczak@nmhdu.org.uk
Headspace Toolkit - Updated
The popular Headspace toolkit for children and young people admitted to inpatient wards has been update. This toolkit, which was developed by Advocacy in Somerset, explains to young people what their rights are, and helps them to self advocate using a set of tools which can help them to take part in their own care planning. Printed copies will be sent to Tier 4 units and it can be downloaded from http://www.headspacetoolkit.org
Rethink Leaflet for Service Users and Carers
Rethink has produced a leaflet for parents and carers, which will be sent to community and inpatient teams. This can be downloaded from: http://www.rethink.org/about_mental_illness/who_does_it_affect/children_and_mental_illness/index.html. It is also available as an easy print black and white version.
Planning Tool
A planning tool for areas wishing to examine their inpatient and community resources and model over a 5 year period changes in service provision, considering the consequences in other parts of the system and also the economic consequences of remodelling. This can be downloaded from
http://www.apho.org.uk/resource/view.aspx?QN=CHMTSMOD
